Sverker Sikström

Vasudha Varadarajan, Sverker Sikström, Oscar N. E. Kjell et al.

Mental health issues differ widely among individuals, with varied signs and symptoms. Recently, language-based assessments have shown promise in capturing this diversity, but they require a substantial sample of words per person for accuracy. This work introduces the task of Adaptive Language-Based Assessment ALBA, which involves adaptively ordering questions while also scoring an individual's latent psychological trait using limited language responses to previous questions. To this end, we develop adaptive testing methods under two psychometric measurement theories: Classical Test Theory and Item Response Theory. We empirically evaluate ordering and scoring strategies, organizing into two new methods: a semi-supervised item response theory-based method ALIRT and a supervised Actor-Critic model. While we found both methods to improve over non-adaptive baselines, We found ALIRT to be the most accurate and scalable, achieving the highest accuracy with fewer questions (e.g., Pearson r ~ 0.93 after only 3 questions as compared to typically needing at least 7 questions). In general, adaptive language-based assessments of depression and anxiety were able to utilize a smaller sample of language without compromising validity or large computational costs.

Vasudha Varadarajan, Hui Xu, Rebecca Astrid Boehme et al.

Recent advances in large language models (LLMs) offer new opportunities for scalable, interactive mental health assessment, but excessive querying by LLMs burdens users and is inefficient for real-world screening across transdiagnostic symptom profiles. We introduce MAQuA, an adaptive question-asking framework for simultaneous, multidimensional mental health screening. Combining multi-outcome modeling on language responses with item response theory (IRT) and factor analysis, MAQuA selects the questions with most informative responses across multiple dimensions at each turn to optimize diagnostic information, improving accuracy and potentially reducing response burden. Empirical results on a novel dataset reveal that MAQuA reduces the number of assessment questions required for score stabilization by 50-87% compared to random ordering (e.g., achieving stable depression scores with 71% fewer questions and eating disorder scores with 85% fewer questions). MAQuA demonstrates robust performance across both internalizing (depression, anxiety) and externalizing (substance use, eating disorder) domains, with early stopping strategies further reducing patient time and burden. These findings position MAQuA as a powerful and efficient tool for scalable, nuanced, and interactive mental health screening, advancing the integration of LLM-based agents into real-world clinical workflows.